Starting Therapy (Again)

I am no stranger to therapy.

Some of it has been better than others; I dropped out of CBT for anorexia because I hated it (although I think that was more the therapist than the therapy itself), but other than that I’ve pretty much stuck it all out. I have always come away learning something new about myself.

The most valuable treatment I ever had was interpersonal therapy under the Eating Disorders Service. My therapist, Mike, was amazing and I owe so much to him. Although I don’t consider myself ‘recovered’, learning the function of my eating disorder was what finally helped me to start letting it go. What we discovered is, essentially, that I don’t understand feelings. I don’t really feel like I have any. Yes, this is stupid. Everyone has feelings. But it turns out that when you are starving, you don’t really feel much else. I didn’t really feel sad, or worried, or angry, because all I felt was hungry.

I can’t say I’m much better at acknowledging my feelings really, and I’m certainly no better at talking about them. But at least I realise what I am doing now. I didn’t really feel anything for so long that I find it very hard to name feelings – I guess I am quite childlike in that way. If someone asks me how I am, I am always ‘fine’. It’s a knee-jerk reaction.

Having been out of therapy since being discharged from the ED Service in 2013, I am now embarking on a new course of Integrative Therapy through the Community Mental Health Team. Mental health teams are incredibly stretched and I’m so grateful not only to my care co-ordinator for helping me to access it, but to the psychologist for helping me to organise things around work to make it as accessible as possible for me.

After my relapse late last year, I found things really difficult. My first session was about finding out what to get from this course of therapy and where my difficulties are. A lot of my problems are sadly, still the same. I am a chronic perfectionist, associate my worth with my achievements and have a huge fear of failure. All of these things were significant contributors towards my anorexia. This is difficult for me as I am known to be a high achiever, a ‘Type A’, a serial hard worker. Other people view these traits as valuable and part of who I am, and I do too. I also struggle with feeling as though I’m out of control (again – hello anorexic brain?!), and all of these elements together helped us to come up with exactly why I took this recent manic episode so hard. I felt out of control and I viewed it as a sign that I wasn’t successful at managing my mental health, meaning that I had personally failed and as such was no longer able to do everything perfectly.

The problem with being such a perfectionist is that it is a trait that is highly valued and has actually served me very well in life and led to many of my successes, so it’s hard to feel like I want to challenge it. But I know that for the good of my mental health, I have to set myself realistic goals to allow in a bit of self care. I am aiming, by the end of the eight weeks, to spend five evenings a week not working. Not writing, not investing my time in my social media presence, not preparing things for my shop. Not doing one of the other 101 tasks I set myself. Spending time just for me. I think (I hope?) that maybe I can achieve that.

I also wanted to work on accepting my diagnosis. I talk very openly about having bipolar disorder and it would appear that I have very much accepted this as a part of myself. The truth is that I was diagnosed then left to process it alone. This is a serious, disruptive and lifelong illness, and having little support to absorb that has obviously had an impact. That impact being that I was so well (the most well I have ever been), for such a long time, that I became very detached from the diagnosis. When I became unwell again last year, I felt like I was dealing with it as though it was brand new again. I have to accept that no matter what I do, no matter how well I look after my health and take my medication, I will always have this illness. And ultimately, that means that I’m not really in control at all. That is a feeling I find absolutely intolerable but I am determined that this time, I am not going to starve to feel like I am regaining it. I am going to sit with it, and with the help of my psychologist, I am going to get through it.

I have never considered myself to be anxious, unless it is about performance related tasks that I want to do well at (exams, assignments, interviews). I am outgoing, I enjoy public speaking, I am happy being in large groups of people. I rarely feel the physical symptoms of anxiety therefore I assume I don’t feel it mentally. But as it turns out, I am perpetually anxious because my intense fear of failure and unrelenting imposter syndrome never leaves me. This is good for me to know. If I know it exists, maybe I can start to notice it and challenge it too.

So, this is the start of the journey. I hope you’ll sit with me for the rest of it.


  1. I’m coming to think that managing your mental health is a lifelong thing. I find it difficult to accept my low periods and they always make me feel like a failure. I’m also fortunate to have a brilliant counsellor who helps me to better understand myself, but I do wish I was simpler and could just live without having to work out why I feel the way I do. Look after yourself.

    Liked by 1 person

    • Think you’re absolutely right and I completely feel those same frustrations. I’m so glad to hear you’ve got some great support though – it’s absolutely vital! It’s a lifelong job but we will get there x

      Liked by 1 person

  2. Cara,
    I totally understand sweetheart, I’m a complete perfectionist and it screws with me, I’m not an over achiever I went into exams at school and mentally shut down.

    In hindsight this May be where and when my mental illness started, I find I have trouble with therapy because I hold everything close, I can’t let anyone see a weakness and use it against me.

    I am a borderline workaholic when I was 11 I had 3 paper rounds 1 morning, 1evening and 1 weekend then from 14 I had a job in the shop as well and when I went to college I had 2 jobs and full tim education. 1 Year I had a driving job which was 56 hour week plus I was renovating a hotel for a friend at least 70 hours a week, if I wasn’t working I wasn’t happy.

    You’re an inspirational woman I’m so proud of what you’ve already done and what you’re now doing for yourself and others, I hope you continue on this journey with the same commitment and courage you’ve already shown, I hope you’ll let me to follow and support your journey

    Clive xx

    Liked by 1 person

  3. I have the same challenges with perfectionism and imposter syndrome, and it makes some days/situations very difficult. It makes me want to give everything up, even though I’ve worked hard on it. I start thinking it’s not “good enough” or that I don’t deserve it, and I hate it, so I can relate to how those feelings trip you up.

    You are an amazing young lady, and I’m glad you’re accessing more help as part of your journey. I hope it’s beneficial to you, and I’m rooting for you all the way.

    Liked by 1 person

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